A new provision to the Minnesota Civil Commitment Act is called voluntary engagement. The purpose is to allow counties to develop relationships with people with mental illnesses in order to intervene early when symptoms are appearing or reappearing instead of waiting until they are a danger to themselves or others.
In order to be eligible for engagement services, the person must be at least 18 years old, have a mental illness, and either (1) be exhibiting the signs of a serious mental illness such as hallucinations, mania, delusional thoughts, or inability to care for themselves; or (2) they have a history of failing to adhere with treatment for their mental illness that has been a key factor in the past for a hospitalization or incarceration, and the person is now showing the symptoms that may lead to hospitalization, incarceration, or court-ordered treatment.
Engagement services include assertive attempts to engage the individual in mental health treatment, engaging the person’s support network including educating them on means restriction and suicide prevention, and meeting the person’s immediate needs for food, housing, medication, income, disability verification and treatment for medical conditions.
Engagement services must consider a person’s personal preferences and can last for up to 90 days. They must be person-centered and can be provided even if someone is in jail.
Services end if the person meets the criteria for civil commitment or if the person agrees to voluntary treatment. When an individual agrees to voluntary treatment, the engagement team must facilitate the referral to an appropriate mental health provider including help obtaining insurance. Engagement staff can be county staff or through a contracted agency. They can include, but are not limited to, members of a mobile crisis teams, certified peer specialists, and homeless outreach workers.
NAMI Ramsey County wrote a letter to county commissioners in support of this new provision. You can, too!
Voluntary Engagement is voluntary for counties, which is why it’s important that you reach out to your county commissioner.
Not sure what to say to support? Check out the guide below!
Author: nami minnesota
Post & guide written by NAMI Minnesota.
Report: NAMI Ramsey County Listening Session on
Police Interaction in Mental Health Crises
In an effort to better understand the dynamics of police interactions with people during a mental health crisis, NAMI Ramsey County (National Alliance on Mental Illness) organized a listening session for people who have experienced these encounters. The goal of the session was to learn more and to provide information to lawmakers and law enforcement regarding how the interactions are experienced by those in crisis.
Statistics collected during recent years indicate an alarming increase in these interactions and the all-too-often fatal outcomes. National Public Radio (Sept. 18, 2020) reported that, since 2015, “nearly one quarter of all people killed by police officers in America have had a known mental illness.” The Pioneer Press reported on March 31, 2018 that during the previous decade “calls to St. Paul police involving mental health issues have doubled.”
NAMI Ramsey hosted the session on Wednesday, Oct. 28, 2020 starting at 6:30 p.m. on Zoom (due to COVID restrictions). Thirty-one people attended. During the session, four people shared stories of police encounters and four people submitted stories after the event. Most people described events that took place in the last couple of years, but a few described events that spanned the past decade. Those attending were individuals living with a mental illness or their parents. Also, one police officer and one mental health professional attended. During the introduction to the session, those attending were asked to share what was helpful during each encounter and what actions led to a worsening of the situation.
NAMI Ramsey is sharing the results of the listening session with law enforcement and lawmakers in the hope that the personal stories will inform future decisions during this time of change in police departments.
Summary of Stories Shared on Police Interaction in Mental Health Crises
In total, during and after the listening session, eight people shared their stories. One story was recounted by a person with a mental illness. The remaining seven stories were recounted by parents of children with a mental illness.
Of the eight stories, four shared both positive and negative interactions with the police and the remaining four had solely negative interactions.
Three of the eight stories involved the Roseville police. Within these anecdotes, one was negative, the other two involved multiple calls and were judged as mixed. Two of the eight stories shared encounters with Ramsey County Sheriff officers that were both negative. One story involving more than one interaction with St. Paul police was mixed. The other two stories involved non-Ramsey County interactions.
When speakers were asked who they would like to come to their door after calling 911, all agreed that, while people trained in mental health would be ideal, by the time it was a crisis, they preferred both mental health professionals and the police there as back-up.
One story involved a person who was taken involuntarily to the emergency room while officers yelled at her to calm down. Yet, she recalled that she was impressed with the positive encounter she had with an officer who talked kindly to her afterwards.
Unfortunately, one interaction ended with a suicide.
The difficulty of receiving help was a common topic among speakers. In two cases, family members were charged with domestic assault instead of being taken to the hospital. One didn’t get help for another five years. He is now doing well, but has a permanent criminal record. The other person, still untreated, has two warrants and has since fled the state, fearful to return to Minnesota.
One parent said her daughter received wonderful help from the police when she was a teenager and credited them with saving her life many times. Additionally, her daughter received substantial assistance from her school and Northeast Youth and Family Services. However, now that the daughter is an adult, the crisis team will not come out. Furthermore, when she has had to call the police, she mentions they do not always know what to do and in one instance did not believe her.
In one case, mental health workers and the crisis team told a parent that they were not able to do anything since her adult son wasn’t cooperating. The team advised the parent to call the police if things got worse. When the police arrived, they asked the son his diagnosis and when informed that it was schizoaffective disorder, the police told the mother that those with such an illness always act that way. They departed without offering any assistance.
One parent was impressed when the St. Paul police helped her son calm down without an arrest, but also discussed another time when they chased him around the yard. He still is not taking any medication.
One person was very unhappy that the officer never informed the family about the option of taking the family member to the hospital instead of to jail. They only found out about this option when they initiated the civil commitment process.
Conclusion and Recommendations
NAMI Ramsey County hopes that information from these personal stories will help inform future decisions during this time of change in police departments.
The stories show that people with mental illnesses and their families seek:
The goal of NAMI Ramsey is for people in crisis to receive treatment and not jail.
NAMI understands that the problems associated with helping people with mental illnesses, whose brains do not allow them to know they are ill, are very often beyond the scope of law enforcement. We support mental health care being available to people with mental illnesses before a crisis develops. This could include having 911 dispatchers trained to dispatch mental health professionals (or other qualified human services personnel such as social workers or bicultural/bilingual community health workers) instead of the police for non-violent situations. We support Crisis Intervention Team (CIT) training programs for police officers who deal with mental health crises in order to improve the outcomes of these encounters.
We urge Minnesota counties to implement the new voluntary engagement option that was passed into law this year as part of civil commitment reform. This legislation, 253B.041 SERVICES FOR ENGAGEMENT IN TREATMENT, was created by a coalition of mental health advocates led by NAMI Minnesota. This promising law calls for up to ninety days of concerted help from mental health professionals for people who appear to be heading into crisis. The goal is to provide early care, while heading off civil commitment and saving public dollars. We urge law enforcement to join in advocating for this option.
As Saint Paul and Ramsey County move forward with re-evaluating the role of law enforcement, NAMI Ramsey urges decision makers to give special consideration to the needs of people experiencing a mental health crisis and to the needs of their families.
NAMI Ramsey County is an affiliate of NAMI Minnesota. We respond to mental health and mental illness concerns specific to Ramsey County, Minnesota. We support, educate, and advocate for those in our community who live with a mental illness and their families. Our nonprofit is governed by a voluntary board. www.namiramseycounty.org
AUTHOR: NAMI Ramsey listening session work group
This group of volunteers organized, hosted, and summarized the listening session. A special thanks to group chair Jennifer LaForgia and NAMI Ramsey president Mindy Greiling.
Dear County Commissioner:
As you look ahead to a new year, NAMI Ramsey County (National Alliance on Mental Illness) hopes you are preparing to meet the needs of people with mental illnesses and their families.
As you know, the stressors of the COVID-19 pandemic are increasing both the number and severity of mental illnesses for people in Ramsey County, and the M-Health Fairview system is closing the St. Joseph’s emergency room and is likely to close the entire hospital at the end of 2021. This will be a 16% decrease in the number of inpatient psychiatric beds in the metro area. It is crucial for Ramsey County to consider all options to reduce the strain on scarce inpatient psychiatric beds.
Toward that end, we urge you to support a promising new law to intervene early and prevent hospitalizations for people with mental illnesses called Services for Engagement in Treatment. NAMI Minnesota joined with other key stakeholders-–including the Association of Minnesota Counties–-to pass this comprehensive update of Minnesota’s civil commitment law, including adding this new option.
Services for Engagement in Treatment is voluntary for counties. Each county must opt-in to offer this intervention. We urge you to adopt this new service and prevent the unnecessary hospitalization, incarceration, or commitment of people with serious mental illnesses. This new intervention is designed to voluntarily engage a person in treatment early in the process, when someone is either exhibiting the symptoms of a serious mental illness for the first time or exhibiting the patterns or behaviors that have previously led to hospitalization, incarceration, or a civil commitment.
We could give you many examples in Ramsey County where family members are told that they must watch their child or loved one decompensate until they meet the criteria for a civil commitment.
Services for Engagement in Treatment is a new law to break this cycle.
If Ramsey County opts in, families and others could contact pre-petition screening at the county and ask for help. Engagement services include assertive attempts to engage the individual in mental health treatment, engaging the person’s support network (family) including educating them on available services and suicide prevention, and meeting the person’s immediate needs for food, housing, medication, income, disability verification and treatment for medical conditions. Engagement services must consider a person’s personal preferences and can last for up to 90 days. Engagement services must be person-centered and can be provided to people who are in jail. Services end if the person meets the criteria for civil commitment or if the person agrees to voluntary treatment.
The needs of the mental health community are increasing while the number of hospital beds is decreasing. We urge Ramsey County to do whatever it can to divert people from hospitalization. High on that list is offering Services for Engagement in Treatment to better serve people with mental illnesses. Thank you for your time and consideration. Our board would be happy to answer your questions.
Mindy Greiling, President
Board of Directors NAMI Ramsey County
Author: NAMI Ramsey county board
With guidance from NAMI Minnesota